The paper, entitled “Applying COM-B to medication adherence – A suggested framework for research and interventions” published in The European Health Psychologist, examines how psychological modeling can be used to support patients in using their treatments as prescribed1.

Given that the international healthcare community could save $269 billion by improving medication adherence2, this review represents a paradigm shift in how the challenge of non-adherence can be addressed.

Dr. Christina Jackson, Ph.D, lead author and Senior Health Psychology Specialist at Atlantis Healthcare noted: “As specialists in patient adherence programs, we wanted to show the rigor behind an approach that is grounded in health psychology. We chose to use the COM-B model as the focus for our review as it provides a more comprehensive explanation of human behavior than existing models that tend to stop short of explaining what the behavior is, or providing suggestions for changing behavior.”

The COM-B model, first published in 2011, proposes that an individual’s behavior is influenced by many factors, all of which can be grouped into three components: motivation, capability and opportunity3. The model was developed with specific interventions to address each component. Dr. Jackson and her co-authors are the first to apply the COM-B framework specifically to examine behaviors that drive non-adherence.

In order to identify the wide range of factors associated with non-adherence, Jackson and her co-authors conducted the first comprehensive literature review of three major qualitative and quantitative reviews of treatment adherence/non-adherence, then mapped each of the hundreds of associated factors documented by the research against the COM-B model.

“Our review reinforces the fact that the reasons for non-adherence are complex, and therefore can’t be treated with a simplistic intervention,” says Jackson. “Our new model can be used to explain why individual patients cannot or choose not to follow prescribed treatment. Once we understand the individual motivators and barriers we can create an effective approach, using our cutting-edge digital support solutions, to help each patient self-manage their illness, long-term.”

According to Jackson, the new model is intended to guide both adherence researchers and healthcare practitioners involved in the care of non-adherent patients. The model also serves as the foundation for Atlantis Healthcare’s proprietary approach to the design of highly personalized and scalable adherence interventions for pharma, payers and healthcare institutions worldwide.

About the review authors from Atlantis Healthcare

Dr Christina Jackson

Atlantis Healthcare

Christina’s academic research has focused on adherence issues. Her doctoral thesis involved development of a measure of factors associated with non-adherence, and creation of an online intervention that successfully reduced concerns about medicines for Inflammatory Bowel Disease (School of Pharmacy, University of London). Previously, Christina worked on adherence-related projects at the Centre for Behavioural Medicine (School of Pharmacy). Christina’s research interests are in adherence, online methodologies, development of measures, intervention development and evaluation.

Dr Lina Eliasson

Atlantis Healthcare

Lina obtained her PhD in health psychology at the School of Pharmacy, University of London, and subsequently continued her research, which focused on treatment adherence in haematological malignancies, at Imperial College London. Lina’s expertise range quantitative and qualitative research methods, statistics and development of behavioural theory and measurements.

Professor John Weinman

King's College & Atlantis Healthcare

Professor John Weinman is Professor of Psychology as applied to Medicines, Institute of Pharmaceutical Sciences, King's College London and is the head of the health psychology team at Atlantis Healthcare. He is recognised as one of the founders of modern health psychology and his main research areas are cognition and health, communication and decision-making in healthcare, and self-regulation and self-management in chronic illness.